Mr. Chairman, Members of the Committee, we are pleased
to be here today to
discuss the FY 1998 budget request for the Office of the Director (OD). As you know,
the OD provides leadership, coordination and policy direction for the overall extramural
and intramural research and research training programs of the various Institutes and
Centers (ICs), as well as the special offices within the OD. The office also provides
management leadership and centralized support activities essential to the operations of
the entire NIH.
The NIH Institutes and Centers (ICs) conduct medical research programs to
foster scientific discovery and to disseminate advances in scientific and medical
applications to NIH's stakeholders - - health care providers and their patients, and the
general public. Furthermore, the ICs support initiatives within the research community
to accomplish these two objectives through their infrastructure programs related to
research training and facilities. The OD facilitates and encourages the attainment of
these objectives through its program direction and central support offices. This is
accomplished by a trans-NIH focus that emphasizes IC-wide cooperation in special
programs to improve the health of women, minorities, and the medically underserved; to
support research in the social and behavioral sciences; and to encourage research on rare
diseases, dietary supplements and alternative and complementary medicine. These
coordinated efforts are focused in the OD and are the responsibility of specially
designated offices and programs. With such cooperation, we hope to continue to
improve the health of the Nation and decrease the burden of disease and disability
through research. I will describe in further detail the offices that carry out these
functions in the OD.
Office of Research on Women's Health (ORWH)
The ORWH budget request will allow this office to continue its role as the focal
point for research in health and disease areas that appear to affect women. Funding will
enable ORWH to assess compliance with revised policies regarding the inclusion of
women and minorities in research studies, continue activities to assure that all NIH
research studies include women and minorities as subjects, and continue programs to
increase the number of women in biomedical research careers.
The Office of Research on Minority Health
The budget request for the Office of Research on Minority Health (ORMH) and
the Minority Health Initiative (MHI) provides continued funding for a series of multi-year
research studies aimed at improving the health of minority populations and
continuing existing programs to prepare minority scientists for careers in biomedical
sciences.
Current minority health priorities include increasing the number of minorities
who participate in clinical research studies; conducting research studies that address the
highest priority health needs of minority populations, such as infant mortality, low birth
weight, asthma, and lead exposure in childhood; and increasing the number, and
scientific skills, of minority scientists engaged in research.
Office of Behavioral and Social Sciences Research (OBSSR)
It is clear that behavioral patterns and social status are risk factors in an array of
health problems. The budget request for the OBSSR will enable the office to stimulate
research in the behavioral and social sciences and to disseminate findings from this
research to the public. Such efforts will include a trans-NIH initiative for research on
the four leading health risk factors in the U.S. - - physical inactivity, smoking, diet, and
alcohol abuse. OBSSR is joined in this initiative by the National Center for Research
Resources, the National Institute on Drug Abuse, the National Institute of Nursing
Research, and the National Institute of Dental Research.
The Office of Disease Prevention
Maintenance of health and prevention of disease are critical to the length and
quality of life. All of the NIH institutes and centers have programs in prevention
research which are coordinated by the Office of Disease Prevention (ODP), as follows:
The Women's Health Initiative
The Women's Health Initiative (WHI), a $628 million, 15-year project involving
164,500 women, aged 50-79, is a trans-NIH activity which focuses on strategies for
preventing heart disease, breast and colorectal cancer, and osteoporosis in older women.
The 1998 budget request of $54.719 million reflects a planned decrease from last year's
level, since it is based on completion of the recruitment phase of the study in May 1998.
As such, the Initiative continues to be on budget and on schedule. In addition, we
expect to reach our goal of 20 percent participation in the study by minority women. As
of December 31, 1996 over 16 percent of the 91,000 women recruited were from
minorities, probably the largest number of minority women ever studied in the United
States.
The Office of Alternative Medicine
Alternative medicine is becoming increasingly popular, and it is expected that
research in this area will help to identify new and effective practices. The Office of
Alternative Medicine (OAM) has been established to investigate and validate alternative
medical therapies, and to recommend a research program to fully test the most
promising of these practices. Alternative medical practices include the use of herbal
medications, homeopathy, and acupuncture. The budget request for the OAM includes
funds to support collaborative research and training efforts in complementary and
alternative medical practices in areas such as cancer, addictions, asthma and in the study
of pain. In FY 1998 we also plan to award and continue support of a yet to be selected
Congressionally mandated chiropractic center to foster chiropractic-related research.
Another part of the disease prevention activities concerns rare diseases - - those
diseases having a prevalence of 200,000 or fewer cases per year in the U.S. The ODP's,
Office of Rare Diseases Research (ORDR) provides information on rare diseases and
conditions, and links investigators with research activities on those diseases. The
budget request will enable ORDR to continue to stimulate research endeavors that
provide criteria for diagnosing and monitoring these rare conditions and disorders.
The Office of Dietary Supplements (ODS) was established in
FY 1996 to support research related to the use of dietary supplements, their health
benefits and their role in disease prevention. The ODS budget request for FY 1998 will
enable the office to stimulate research on the use of dietary supplements through grants,
conferences and workshops, and to conduct a study to determine what type of
information is needed to respond to public questions regarding the use of dietary
supplements.
Other OD Activities
As noted before, other OD entities such as the Office of Extramural Research
(OER), the Office of Intramural Research (OIR), the Office of Science Policy (OSP),
and the Office of Management, provide leadership in regard to the overall extramural,
intramural, and management activities of NIH, setting policies and defining goals that
enable ICs to effectively and efficiently fulfill their missions.
In addition, the OER coordinates the Academic Research Enhancement
Award (AREA) program that provides grants to those institutions that award degrees in
health sciences but are not major recipients of NIH grant funds.
The OIR coordinates NIH's loan repayment and scholarship programs. This
year the request includes funds to initiate a new Clinical Research Loan Repayment
Program to repay the educational loans of clinical investigators conducting research in
extramural programs supported by NIH. Fifteen awards will be made under this new
program, in addition to those made currently. The OIR also manages the Undergraduate
Scholarship Program for Individuals from Disadvantaged Backgrounds. This program
provides scholarships of up to $20,000 per year, in return for which the students agree
to participate in 10 weeks summer employment at the NIH and a year of service after
graduation for each year of scholarship. There are currently 13 individuals enrolled, all
of whom are under-represented minorities. OIR also oversees the care and use of
research animals, and is responsible for the high standards in this area that have led to
AALAC accreditation of the animal facilities within NIH.
The Office of Science Policy (OSP) coordinates all phases of science policy and
science education, and addresses issues in areas in which science interfaces with society
at-large, such as the privacy of medical and genetic information collected during clinical
trials or in the performance of human genetic therapy protocols. The OSP also
coordinates a number of science education activities that benefit both students and
teachers.
Other OD offices provide the public with science-based health information,
advise the Director on legislative issues, and provide policy direction to assure that NIH
personnel have equal employment opportunities. In this respect, I am happy to report
continuing progress in maintaining a diverse workforce within OD with increases in
each minority group and in the placement of minorities in all grade levels including
senior level employment. In addition, OD has introduced alternate dispute resolution
techniques to resolve employee issues and this program achieved a resolution rate of 98
percent last year.
As part of our request for FY 1998, we have included a provision that would
allow NIH to collect up to $15 million in third party payments for services provided at
the Clinical Center. We began this collection process this year, and will continue to
seek reimbursements wherever possible.
Continuing NIH's efforts to improve management, at the request of Chairman
Porter, the NIH has initiated a comprehensive review of its administrative structure and
associated costs to document the effectiveness of current practices and to identify areas
for future improvements. The effort is intended to cover Research Management and
Support costs and those administrative costs financed by the intramural research
program. The review is being led by a Project Director who is managing an outside
contract effort aimed at further conceptualizing and formally conducting the review
itself. The Project Director serves as chair of an Advisory Committee that is assisting in
overseeing the contractors' efforts, and in reviewing recommendations for enhancing
administrative efficiency that emerge from the review. This arrangement will bring
together the objectivity of an independent contractor with the knowledge and expertise
of NIH managers. It is expected that the study will identify best practices for a range of
administrative functions that could be adapted across the agency.
The FY 1998 budget request for the Office of the Director is $234.2 million. I
will be pleased to answer questions.
